If you have been thinking about breast augmentation in Perth and noticed that your chest or breasts sit unevenly, you are not alone. Some degree of asymmetry is present in most people, and for many patients considering augmentation, the underlying chest wall structure plays a bigger role in surgical planning than they might expect.
This article explains what chest wall asymmetry means in a surgical context, how it is assessed, and what you should know before attending your first consultation with a Specialist Plastic Surgeon in Perth.
What Is Chest Wall Asymmetry?
The chest wall is the structural framework of the thorax, including the ribs, sternum, cartilage, and overlying soft tissue, forming the base on which the breasts rest.
This is more common than most people realise. Common presentations seen in patients considering augmentation include:
- Pectus excavatum – a concave depression of the sternum and lower ribs, which can make the chest appear sunken in the centre
- Pectus carinatum – a protrusion of the sternum, creating a rounded forward projection
- Scoliosis – lateral curvature of the spine that causes the chest wall and rib cage to sit at different heights on each side
- Rib flaring – one side of the lower rib cage is more prominent, causing the breast on that side to project differently
- General thoracic asymmetry – subtle, often undiagnosed differences in the overall shape or height of the chest wall
Most people are unaware of these differences until they are pointed out during a surgical consultation. When planning breast augmentation, understanding the chest wall is an important consideration.
How Chest Wall Asymmetry Affects Breast Augmentation Planning
Breast augmentation involves placing implants to alter the size, shape, and projection of the breasts. When the foundation, the chest wall, is uneven, standard planning may not produce a symmetrical result. This is not a reason to avoid surgery, but it is a reason to approach planning carefully.
Implant Selection
In many cases of chest wall or breast asymmetry, different implant sizes, profiles, or shapes are used on each side. The aim is not to achieve mathematical symmetry, which is rarely possible, but to plan an approach that considers the patient’s underlying anatomy. Outcomes vary between individuals and are directly influenced by the degree of structural asymmetry present.
Implant Placement
The placement of the implant, whether above or below the pectoral muscle, can be influenced by chest wall anatomy. In cases of pectus excavatum, for example, subglandular placement above the muscle may not provide adequate projection due to the concave underlying structure. Submuscular or dual-plane placement is often considered in these cases. Your surgeon will explain which approach is most appropriate for your anatomy and why.
Pocket Dimensions
The dimensions of the pocket created for the implant are planned in relation to your breast base width and the underlying chest wall. When the chest wall is asymmetrical, the pocket on each side may require different dimensions to produce consistent projection.
Managing Realistic Expectations
One of the most important conversations during a breast augmentation consultation involves discussing realistic expectations. Patients with chest wall asymmetry should understand that surgery may address certain anatomical differences; however, pre-existing structural variations in the chest wall can still be noticeable to some degree after the procedure. These considerations are discussed openly during consultation so patients can make informed decisions about treatment options.
Implant Safety: What Perth Patients Should Know in 2026
Implant safety remains an active topic in Australia. The Therapeutic Goods Administration (TGA) has previously taken action regarding certain textured breast implants and their association with Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a rare form of lymphoma.
When planning breast augmentation, your surgeon will discuss current implant options, including the type of implant surface and the evidence around safety. The available options and recommendations have changed over recent years and your surgeon should be up to date with current TGA guidance. This is part of the informed consent process.
What to Expect at Your First Consultation
A first consultation with Dr Mark Hanikeri involves a thorough clinical assessment. This is not a brief discussion. It is a detailed evaluation that takes the time needed to understand your anatomy and your goals.
During the consultation, the following are assessed:
- The degree and nature of any breast asymmetry
- Chest wall structure, including any identifiable asymmetry or deformity
- Skin quality and the available soft tissue envelope
- Nipple and areola position on each side
- Breast base width measurements
- Soft tissue coverage and thickness
This information is used to develop a surgical plan specific to your anatomy. A recommendation is only made after this assessment is complete, not before.
What to Bring to Your Consultation
To make the most of your consultation, it helps to:
- Write down your questions in advance – it is easy to forget things once you are in the appointment
- Be clear about what concerns you most – whether that is size, shape, symmetry, or something else
- Bring a support person if you would like one present
- Be prepared to discuss your medical history, any previous surgeries, and current medications
The Informed Consent Process
Before any procedure is undertaken, a detailed informed consent process takes place. In line with AHPRA guidelines, patients must have adequate time to consider all information before consent is finalised. You will not be asked to consent on the day of your first consultation.
The consent discussion covers:
- The proposed surgical approach and the reasoning behind it
- Potential risks and complications, including those specific to patients with chest wall asymmetry
- The limitations of what surgery can achieve given your individual anatomy
- What recovery involves and what to expect during the healing process
- The possibility that revision surgery may be required
Frequently Asked Questions
Can breast implants correct chest wall asymmetry?
Breast implants are placed within the breast tissue and are not able to structurally alter the chest wall itself. However, careful implant selection and placement planning can compensate for some of the visual effects of chest wall asymmetry, which may change how asymmetry presents visually. The degree of change depends on the nature and severity of the underlying structural difference.
Will my asymmetry be obvious after breast augmentation?
In some cases, surgical planning may take existing anatomical differences into consideration. However, when structural differences in the chest wall are present, some degree of asymmetry may remain noticeable after surgery. These factors are discussed openly during consultation so patients can understand the anatomical considerations involved and make informed decisions about their treatment options.
Is breast augmentation with chest wall asymmetry more complex?
It can be. The planning process requires more detailed assessment and may involve different implant choices on each side. The procedure itself is not necessarily more complex in all cases, but the surgical planning is often more involved than for a patient with a symmetrical chest wall.
Does chest wall asymmetry affect implant placement choice?
Yes, in some presentations it does. The degree of projection available, the soft tissue thickness, and the shape of the underlying chest wall all influence whether subglandular, submuscular, or dual-plane placement is most appropriate. This is evaluated individually at consultation.
Next Steps for Perth Patients
If you are considering breast augmentation in Perth and have questions about how your chest wall anatomy might affect the planning process, a consultation with a Specialist Plastic Surgeon is the appropriate starting point. A consultation with Dr Hanikeri involves a thorough clinical assessment before any recommendation is made.
Dr Mark Hanikeri holds FRACS in Plastic and Reconstructive Surgery and has been practising in Perth for over two decades. Consultations are conducted at accredited facilities.
Further Reading on Breast Augmentation
- Breast Augmentation Perth – markhanikeri.com/breast-augmentation-perth/
- Breast Augmentation Techniques – markhanikeri.com/breast-augmentation-techniques/
- Implant Settling Process – markhanikeri.com/breast-augmentation-perth-implant-settling-process/
- Breast Implant vs Fat Transfer Augmentation – markhanikeri.com/breast-implant-versus-fat-transfer-breast-augmentation/
- Implant Profiles and Sizes – markhanikeri.com/implant-profiles-vs-sizes/
| This article has been written by Dr Mark Hanikeri, FRACS (Plastic and Reconstructive Surgery), based on clinical experience assessing and operating on patients with chest wall and breast asymmetry in Perth. It is intended as general educational information only and does not constitute medical advice. Individual circumstances vary. |
